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Table 2 Comparison of the diagnostic evaluation parameters for direct KOH examination, culture, and biopsy according to the methodological quality of the studies

From: Meta-analysis of the utility of culture, biopsy, and direct KOH examination for the diagnosis of onychomycosis

 

KOH (95% CI)

Culture (95% CI)

Biopsy (95% CI)

Positive subjects: True Positives/False Negatives

 Total

857/545

966/745

1,483/288

 High quality

677/453

684/448

975/236

 Average quality

180/92

282/297

508/52

Negative subjects: True Negatives/False Positives

 Total

690/33

808/6

881/105

 High quality

622/28

643/5

709/92

 Average quality

68/5

165/1

172/13

Sensitivity

 Total

61 (59–64)

56 (54–59)

84 (82–86)

 High quality

60 (57–63)

60 (58–63)

81 (78–83)

 Average quality

66 (60–72)

49 (45–53)

91 (88–93)

Specificity

 Total

95 (94–97)

99 (98–100)

89 (87–91)

 High quality

96 (94–97)

99 (98–100)

89 (86–91)

 Average quality

93 (85–98)

99 (97–100)

93 (88–96)

Positive likelihood ratio

 Total

9.6 (1.0–95.1)

17.3 (6.1–48.8)

7.2 (2.8–18.9)

 High quality

8.5 (0.3–255.7)

17.7 (3.4–91.8)

4.4 (1.4–13.8)

 Average quality

9.6 (1.8–51.9)

16.6 (5.4–50.8)

24.3 (0.9–631.9)

Negative likelihood ratio

 Total

0.4 (0.3–0.5)

0.45 (0.4–0.5)

0.2 (0.1–0.3)

 High quality

0.4 (0.3–0.5)

0.4 (0.3–0.5)

0.3 (0.2–0.4)

 Average quality

0.4 (0.2–0.6)

0.5 (0.4–0.7)

0.1 (0.0–0.21)

Diagnostic OR

 Total

27.0 (9.8–73.9)

44.7 (17.9–111.5)

44.6 (13.0–153.5)

 High quality

28.0 (7.4–106.3)

53.9 (12.7–229.1)

16.4 (4.2–64.8)

 Average quality

25.5 (4.4–159.7)

32.3 (10.0–104.3)

249.1 (75.5–822)

Positive predictive value

 Total

96.3 (96.2–96.4)

99.4 (99.3–99.5)

93.4 (93.3–93.5)

 High quality

96.0 (95.9–96.1)

99.3 (99.2–99.4)

91.4 (91.3–91.5)

 Average quality

97.3 (97.0–97.6)

99.6 (99.5–99.8)

97.5 (97.4–97.6)

Negative predictive value

 Total

55.9 (55.8–56.0)

52.0 (51.9–52.1)

75.4 (75.3–75.5)

 High quality

57.9 (57.8–57.9)

58.9 (58.8–59.0)

75.0 (74.9–75.1)

 Average quality

42.5 (42.1–42.9)

35.7 (35.6–35.8)

76.8 (76.5–77.0)

Youden index (J)

 Total

0.57

0.56

0.73

 High quality

0.56

0.60

0.69

 Average quality

0.59

0.48

0.84

Efficiency

 Total

72.8 (72.7–72.9)

70.3 (70.2–70.4)

85.75 (85.7–85.8)

 High quality

73.0 (72.9–73.1)

74.55 (74.5–74.6)

83.7 (83.6–83.8)

 Average quality

71.9 (71.7–72.1)

60.0 (59.9–60.1)

91.3 (91.2–91.4)

Prevalence% (95% CI)

 Total

66.0 (65.9–66.1)

67.8 (67.7–67.9)

64.2 (64.2–64.3)

 High quality

63.5 (63.4–63.6)

63.6 (63.5–63.7)

60.2 (60.1–60.3)

 Average quality

78.8 (78.7–79.0)

77.7 (77.6–77.8)

75.2 (75.1–75.3)